Individual
JOHN CARLO SHUN BASE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OTR
Contact information
Practice address
359 VILLAGE COMMONS BLVD, GEORGETOWN, TX 78633-4448
(512) 277-6405
(512) 277-6406
Mailing address
150 KLATTENHOFF LN, APT 2104, HUTTO, TX 78634-4601
(512) 987-8718
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
117013
TX
Other
Enumeration date
09/03/2008
Last updated
02/13/2017
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